Revolutionary Rehabilitative Care at MEDIAN Hospital Group

Since 2011, Dr. André M. Schmidt has served as the CEO of the MEDIAN Hospital Group, Europe’s largest provider for post-acute and rehabilitative care. Prior to this, Dr. Schmidt worked for 6 years for McKinsey & Company and held various high-level operative positions with different post-acute and nursing care provider.

He studied biochemistry at Leibniz University of Hannover with a special focus on theoretical chemistry. In 1998 he received his PhD in bio-chemistry from the Technical University Darmstadt, Germany.

The MEDIAN Group operates 120 rehabilitation clinics, post-acute care clinics, therapy centers, outpatient clinics and reintegration facilities with a total of 18,700 beds and treatment places. Every year, about 240,000 patients are cared for across 13 states. With a revenue of about €1 billion, MEDIAN is Europe’s largest provider of post-acute care and the fifth largest private clinic operator in Germany.

MEDIAN has been disruptive in the German post-acute market through and strong focus on medical quality, bridging several levels of care (acute, post-acute/rehabilitation, sociotherapy), an aggressive growth strategy, increasing its sizes by factor 14 over the last 8 years, and a focus on digitalization and innovation.

What are the different treatment areas that you provide at MEDIAN clinics?

MEDIAN has a high level of specialist medical expertise in the fields of post-acute and rehabilitative care in the fields of neurology, cardiology, orthopedics, mental health/psychiatry, addiction disorders, and sociotherapy. In contrast to acute clinics, it is our key goal to help patients recover and return to their social and work-life.

How do you improve your science and research in order to advance your available treatments, therapies and medicines over time?

The foundation of everything we do is the knowhow of our physicians, therapists and nurses. We bundle this knowhow in our Medical Boards, which come together several times a year and comprise all chief physicians in any given medical field. Our Medical Boards are the focus point, where treatment standards are developed based on external scientific evidence and the experience of our physicians. In the board meetings our physicians also have agreed on medical outcome parameters, which are collected at various points along the patient journey.

Currently we are pooling the process data of therapies rendered to patients in our clinics, outcomes parameters and socio-economic data points of the patient in one single database. Using our patient mobile app, we aim to extend the reach of our data collection process beyond the inpatient stay.

The goal consists of two steps: the first is to compare our outcomes between clinics without the socio-economic bias. In the second step, we aim to use this data to develop new individualized patient pathways, that automaticity allocate a series of treatments that will deliver the best outcomes for the individual patient based on the date of 240,000 patients treated annually.

In pilot projects, we are already using the data collection process to compare different treatment pathways. Our database is currently already used to conduct various studies with external partners, mostly universities, but also with our payers. Thus, we want to transfer into a regular process where we do prospective, randomized, controlled trials as well as retrospective big data analysis on an ongoing basis. We encourage all employees to conduct scientific research. This can also be seen in the publications of our employees: Between 1993 and 2017, employees of MEDIAN published more than 1,000 scientific papers. Scientific research and advanced rehabilitation go hand in hand at MEDIAN.

What steps do you take to maintain the quality and innovation of your service?

As a reliable partner for rehabilitees, patients, residents, payers, cooperation partners and employees, it is essential that we deal with our services and the expectations of our partners in a continuous, critical and quality-oriented manner. In this context, we put great importance on measuring the success rate of treatment regimens as well as patient satisfaction in our clinics. To meet this requirement, we have established a far-reaching internal quality management system in all facilities. The work in hospitals and rehabilitation facilities takes place in a more centralized manner, with the aim of achieving a consistently high quality of therapy and treatment for our patients across all our clinics.

To this end, our Medical Boards have been set up for each medical specialty. At the heart of the work of our Medical Boards is the continued improvements of our patient pathways and therapy standards. Our physicians compare themselves among each other and out of these discussions, a sustainable improvement cycle for our patients is achieved, so we are able to deliver the same high quality across all clinics in our group. At the same time, the Medical Boards are the catalyst for medical innovation at MEDIAN, whether it’s our digital aftercare programs or new treatment options – it is always the chief physicians in these boards that are driving these innovations. From an operational standpoint, it is important to mention that we not only discuss medical outcomes with the physicians but also our management teams.

As such, it is not only economic topics but also medical results that are on the agenda in regular monthly meetings of the senior management and the commercial directors of our clinics. This way, we are ensuring that medical quality is always at the top of everybody’s mind.

What advice would you offer to those who fear the medical rehabilitation process or are just afraid?

For every problem, no matter how hard it is, there is a solution. Even if we cannot heal, we help to get along with the illnesses, which usually means an enormous increase in quality of life for our patients. In our facilities, patients recover based on evidence-based medicine in a holistic approach, so we can ensure all needs are met. It is best to consult with those people who are close to you. To overcome fear, it is important to get the right information. Patients who are well informed can also make empowered decisions. One should always go to the facilities that have many years of experience and the best results, e.g. in the area of ​​quality and therapies. Patients should inquire directly with the clinics and find out what is best for them individually.

Does MEDIAN Clinics have a motto or mission that it runs by?

Our mission is to “live life.” This means we empower patients to return to the life they had prior to the medical incident that brought them into our clinics. To achieve the best results, rehabs take medical, professional and social aspects into consideration at an early stage. Every need a person might have, no matter what life situation they come from, is respected.

Are there any particular factors you hope will advance in medical rehab in the future?

We are pushing for individualized, post-acute care pathways based on hard data evidence, not just experience. This will be a huge step forward. On the other side, digitalization in the medical field will provide new opportunities for patient care. Here we are looking into how we can extend and increase the effects of rehabilitation / post-acute care beyond the inpatient stay in our clinics through digital after care programs. Through these tools and the possibility to communicate via app or telemedicine we can be there for our patients when they need support – not when they get an appointment with their local therapist. We believe that will make a big difference for them.

Healthcare in all industrialized countries has changed massively. Inpatient hospital treatment is getting shorter and shorter, but patients are also getting more and more complex.

For these reasons, it is becoming more and more important to support patients following acute care to enable them to return to their work and social life. Therefore, medical rehabilitation is becoming increasingly important especially in aging societies.

Unfortunately, politicians and policymakers are not fully aware of this. The benefits of medical rehabilitation are not yet considered to be equal benefits in relation to acute medical care. Politicians focus on costs in single areas, like acute hospital care, drugs, nursing homes, or local practitioners etc.; they should however consider the entire patient pathway and then apply an investment logic to make sure we keep improving outcomes while keeping the cost of care on an affordable level. At MEDIAN we are convinced that our concepts deliver that, and that they can be applied in any healthcare system and would always be a cost saver. 

Contact: andre.m.schmidt@median-kliniken.de